FIS looks at the healthcare system from a consumer perspective. What do consumers need to better manage their healthcare and make informed decisions? What are the latest solutions and services that are being introduced to empower consumers?

1. Consumer Engagement Best Practices –
A Profile of an Empowered Patient
David Randall, Executive Director, CDHCi
John Bull, Director CDH Product Strategy, FIS

2. Agenda
• David Randall, Executive Director, CDHCi
– Consumer Directed Healthcare growth
– Consumer engagement past and present
– State of the market
– Future trends and direction
– Key metrics
• John Bull, Director CDH Product Strategy, FIS
– FIS market perspective
– Consumer needs/wants
– The CDH lifecycle
– A few real life examples
– Solution imperatives
2

3. Consumer Engagement Best Practices –
A Profile of an Empowered Patient
Presented by:
David Randall, Ph.D. (A.B.D), Executive Director,
CDHCi and The American Research and Policy Institute,
Washington, D.C.

4. What is Consumer Driven Healthcare?
• The application and use of tools, services and
products that engage, inform and empower
individual consumers of healthcare services to
make healthcare choices in their own self
economic and health interests.
• CDHC removes the problem of Third Party
Payment discussed by Tullock (1965, 1990),
Friedman (1962,1975) and Herzlinger (2004).
• CDHC growth and adoption began after the
passage of the Medicare Modernization Act of
2003 when Health Savings Accounts were created
4

5. Enrollment Growth in HDHP
HDHP Growth
12 10.1
10
8
8 6.1
6 HCHP Growth
4
2
0
2008 2009 2010
HCHP Growth 6.1 8 10.1
AHIP

6. HRA Account Growth and Balances
• More than 5 million accounts as of 2009
• Average account balance of $1,419
• Average roll over balance of $1,295
• Projected growth by 2014 at more than 10
million HRA accounts
• Projected growth of all CDHC accounts to be
more than 22 million by 2014
AHIP

7. Economic Downturn Driving Consumer-driven
Healthcare Adoption
Double-
Double-digit Employers Currently only 17%
healthcare more employers offer a
cost increases aggressive in full replacement
average cost managing their CDH program AND
per-
per-employee health care a MAJORITY of
of health costs Fortune 500 offer
benefits $9,660
Employers Implementing Number of
looking for a Consumer Consumer
options to Driven Driven
decrease the Healthcare Healthcare
cost per program is one programs to
employee of of the leading increase in 2010
health benefits healthcare
strategies for
employers
* Towers Watson, Aon

8. Consumer Engagement: Past and
Present
• Past government efforts
• State-of-the-market: From PHRs to mobile
payment platforms
• Transaction metrics, spending trends from
CDHCi data
8

9. Evolution and Devolution:
• Center for Medicare and Medicaid Services
(CMS) posts prices, industry follows
• Aetna Price Transparency Project
• Personal Health Record (PHRs)
• Online tools − Google and Microsoft
• Price disclosure in post-PPACA environment

10. State of the Market:
• State-based efforts to encourage or
require providers to post prices
• The rise of retail-based healthcare
• CDHC growth trends and
impediments

11. Future Trends and Health Care
Reform:
• Impact of Health Insurance Exchanges
before and after 2014
• Watch the states − where all the action
will be!
• A generational shift away from third-
party payers to CDHC products and
services
• Mobile applications

12. Key Data Metrics:
• CDHCi market data advisory
• Transaction trends
• Mobile payments
• Retail model growth

13. Our Target Consumer:
• Healthcare consumer − Lori S., age 48, white
female
• She is used to low co-pays and has never seen
a price list!
• Question − How to engage her?
• The retail model!
• Keep it simple and make it easy!

14. New Healthcare Retail Model
• Retail 1.0 • Retail 2.0-3.0
• Minute Clinic/CVS
• Nurse Lines • Consult A Doctor
• Use of PHRs • Use of Web-based
• Lower utilization, technologies, 24-7 access
convenience • Higher ROI, reduced
utilization
14

15. CDHCi Market Data
• Beginning in June, 2010 CDHCi launches a
Quarterly Data Advisory Service that will track
account-based plans across a range of metrics,
including:
− Account balances, spending patterns and
healthcare utilization trends, and projections for
future growth.
− Data published quarterly that provides
valuable insight for a range of marketing and
account use purposes.

16. CDHCi Market Data Advisory
Key Data Highlights
• CDH accounts (specifically HSAs) within existing programs,
grew 6.46 percent in Q1.
• Account balances were $592 in individual HSAs, a decrease
from average balances in Q4 ’09. While the average balance
in family HSAs reached $1,408 in Q1 ’10.
• 56 percent of employees in family HSAs contributed to their
accounts, while only 49 percent of employees in individual
plans contributed to their accounts.
• On average, both reimbursements and check transactions
exceeded debit card transactions nearly 2:1 both in
individual and family account spending.
16

17. What this all means
CDH Accounts
• Increasing
60.0
Demand!
Millions of Accounts
23.1 27.3
40.0
16.0
9.3
3.9 10.9 12.9 12.3
7.0
Forrester views adoption 20.0 3.7
of CDH as stronger than
predicted – calling out HSAs 16.5 17.3 16.8 16.3 15.5
as the growth engine.
0.0
2007 2008 2009 2010 2011
FSA Enrollees HRA Enrollees HSA Enrollees
SOURCE: BearingPoint

18. Thank You!
18

19. Consumer Engagement Best Practices
John Bull, Director CDH Product Strategy, FIS

20. FIS Market Perspective − Consumer
Market Observations
• CDH benefits can be complex, confusing and designed a la carte
• Hands on information is a must
• HSAs and HRAs will continue to grow in the future
• Incentives are still drivers
Technology Needs
• Online experience must be intuitive, fun and quick
• Online banking is the barometer for success
• Mobile is the future
• Health Management and Integrated claims must be provided
20

21. Before technology solves everything…
• We need to ask (and answer)…
What does the consumer really want to know?
– What plan should I enroll in?
– What’s the difference between an HSA and an HRA?
– Have my claims been paid?
– What’s my balance?
– What services does my account cover?
– What incentives do I have that I should be aware of?
– How can I save money on healthcare?
– How much is my healthcare going to cost me?
21

22. So, how do we answer these questions…
• There are really just a few ways to answer the questions:
1. Online
2. Phone call to customer service
3. IVR
4. E-mail
5. Online chat
6. Mobile
7. Ask HR
8. Finally, tell them before they think to ask
22

23. Tell the before they ask….???
• How do we tell consumers what they want to know before they even ask?
• The social media world of Facebook and Twitter make pro-active communication an
everyday and expected activity.
• Messages are pushed based on your likes and who you follow. Advertising is
embedded into everything.
• Can we do this for CDH? Absolutely!
23

24. Driving information relies on
understanding the CDH life cycle
Enrollment
Education
Year End Wellness Claims
Management
Price &
Incentives
Quality
Payments
24

25. Let’s take Jane…
• Jane’s 40 with two children
• She has choices at enrollment − an HSA Plan with a deductible of $4,800 or a lower
deductible plan with a funding account.
• How will she decide what to enroll in?
25

26. Jane’s decision making process…
• Jane receives notice from HR as well as an e-mail about enrolling in an HSA
• Jane goes online to learn more about HSAs and which plan is right for her
• She views an interactive video on HSA for someone like her – Sarah who is married,
40 years old and has two children
26

27. Jane’s decision making process…
• Jane likes what she hears, but she wants to forecast what plan is right for her so she
uses the “Which plan is right for me?” planning tool.
1. She enters in her plan information
27

28. Jane’s decision making process…
• Jane likes what she hears but, she wants to forecast what plan is right for her so she
uses the “Which plan is right for me?” planning tool.
2. She enters in her medial expected services
28

29. Jane’s decision making process…
• Jane likes what she hears but, she wants to forecast what plan is right for her so she
uses the “Which plan is right for me?” planning tool.
3. She enters in her tax information and expected HSA Contributions
29

30. Jane’s decision making process…
• Jane likes what she hears but, she wants to forecast what plan is right for her so she
uses the “Which plan is right for me?” planning tool.
4. Based on her unique situation, the HSA looks right for Jane
30

31. Jane’s ready to enroll, but she’s still
not sure…
Jane reads through the FAQs
Now, she’s ready to enroll…
31

32. Now that Jane is enrolled, she can access
her account online or on her mobile device
32

33. Jane not only needs to manage her HSA,
but she needs to manage her overall health
• Jane needs wellness tools, incentives and a personal health record − all in one place,
through one, online experience
PHR
Mobile Wellness
Wellness tools and Health Risk Assessments
33

34. Now, it’s time to communicate!
E-mails and texts Online/mobile self- Online and mobile
• Opt-in/out of service capabilities presentment
communications • Claim submission requirements
• Open enrollment • Enrollment • My deductible status
• New claim received • Bill payment for HSAs • My HRA rollover rules
• Payment made • Funding of HSAs • My HSA contribution
• Debit card mailed • Transfers out for HSA status
• Deductible met • Incentive-based • My claims status
• Incentive completed/ communications and payments
funding received • Mobile balances • Personal health records
• Time to refill • Upload of claims • Wellness information
• and programs
Preventive care notices • Save receipts
• And more • Fun incentives
• Interactive education
• Health savings and
spend forecasting
• Pricing analysis
34

35. To make the consumer engagement a reality, you need
the strong technical and market-focused foundation
• First, you need technology that is
real-time, dependable and
integrated.
• Second, you need to respect the
different communication channels
demanded by consumers.
• Third, you need to allow
users to manage their
communication preferences
• Finally, you need an administrative
and social media engine for driving
the CDH messages.
35

36. Questions and Answers

37. Thank You
John Bull, Director CDH Product Strategy, FIS
john.bull@fisglobal.com
David Randall, Executive Director, CDHCi
drandall@CDHCi.org